Complex Closure with a Soft Tissue Tumor Code

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June 28, 2018

Question:
Can I also bill for the complex repair when I’ve also excised a soft tissue tumor like a lipoma in the 21552-21555 series of codes?

Answer:
Actually CPT says these soft tissue tumor codes include the simple or intermediate repair and a complex repair may be separately reported.  That said, Medicare and many other payors will not reimburse the code because they consider it to be a primary closure.

*This response is based on the best information available as of 06/28/18.

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